Abstract : Background: Numerous studies investigate spatial inequalities in health at a variety of scales, but only few publications compare cities health status in order to better understand relations between these inequalities and cities- social, economical and physical environment. The aim is to identify the relations between, on the one hand, differences in respiratory health between the cities and on the other hand, the cities regional contexts and intra-urban features. This paper focuses on respiratory health disparities between the 55 largest French cities. Methods: Health data used to define urban units- health situations relies on COPD chronic obstructive pulmonary disease hospitalizations in 2008, whereas hospitalizations for all causes are used as a comparative indicator. Classical indicators such as unemployment rates by age group, rates of individuals with no diploma describe the socio-economic dimension of the places. The physical environment is characterized by altitude, temperatures, humidity, pollens and air pollution concentrations nitrogen dioxide, ozone and particulate matter. Residential intraurban inequality indicators such as concentration indexes are also used. Data is analyzed using bivariate methods and multiple regression models. Results: Bivariate analyzes show that most socio-economic and some environmental indicators are highly correlated with cities- COPD rates. Pollution shows a non linear relation with COPD. The multiple regression models combine systematically socio-economic and environmental indicators from different geographical levels: - an unemployment indicator at the regional level; - a climatic indicator at the urban level; - one intraurban residential segregation indicator. In the various models obtained, the atmospheric pollution indicators do not appear as explanatory variables. Conclusion: In this exploratory work, the introduction of variables at different geographical levels, sheds a new light on the relationship between respiratory health status and environmental and socio-economic dimensions.